Acute asthma management considerations in children and adolescents during the COVID-19 pandemic

Abstract

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International expert opinion on the use of nebulization for pediatric asthma therapy during the COVID-19 pandemic

“…The main therapy goal for patients with asthma with or without COVID-19 is minimizing exacerbations and achieving asthma control (38). There are significant risks to a child suffering from a severe asthma attack and these attacks can result in fatal outcomes (34). Therefore, any deviation from planned, individualized asthma therapy, including nebulization, should be avoided wherever possible.…”

“…In those patients with evident improvement following acute treatment in a healthcare setting, nebulization may have to be performed in home settings as a continuation of the acute treatment (33). Withholding nebulization therapy may also lead to respiratory failure in severe cases (34). There are concerns regarding the overabundance of caution that HCPs and health institutions might exercise in their approach to the use of nebulizers that may lead to unfavourable patient outcomes (35).…”

<p>Asthma and COVID-19: In Defense of Evidence-Based SABA</p>

“…2,3 There is wide agreement that management of asthma exacerbation with or without COVID-19 should continue as before with increased frequency of SABA therapy delivered through metered-dose inhaler using a spacer, particularly during the first hour of presentation to the emergency department. 10 We are, in our view, fortunate that both numerous and intense attacks on SABA have not been successful. To phase out SABA, as emphatically called for by these authors, would in our opinion, be a critical error.…”

“…There is wide agreement that management of asthma exacerbation with or without COVID-19 should continue as before with increased frequency of SABA therapy delivered through metered-dose inhaler using a spacer, particularly during the first hour of presentation to the emergency department. 10 …”